Evidence map›Paper›PMID 28258170›Full record

Observational studyCirculation2017

Weight Loss and Heart Failure: A Nationwide Study of Gastric Bypass Surgery Versus Intensive Lifestyle Treatment.

Johan Sundström, Gustaf Bruze, Johan Ottosson, Claude Marcus, Ingmar Näslund, Martin Neovius

Open access · greenAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
81citing papers in PubMed, 6 pooled it
22.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

81 citing papers in PubMed, 6 syntheses or guidelines pooled it, 210 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. The effect of bariatric surgery on patient reported outcomes of heart failure in women: a pilot study.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026
    Article
  9. Review
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  11. Observational
  12. Article
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  15. Article
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  17. Article
  18. Article
  19. The Impact of Obesity on Cardiovascular Diseases: Heart Failure.Methodist DeBakey cardiovascular journal · 2025
    Review
  20. Targeting Obesity for Heart Failure.European cardiology · 2025
    Review

21 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Johan SundströmFrom Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.). johan.sundstrom@medsci.uu.se.
Gustaf BruzeFrom Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.).
Johan OttossonFrom Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.).
Claude MarcusFrom Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.).
Ingmar NäslundFrom Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.).
Martin NeoviusFrom Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Sweden (J.S.); Department of Medicine, Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden (G.B., M.N.); Department of Surgery, Faculty of Medicine and Health, Örebro University, Sweden (J.O., I.N.); and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (C.M.).
Uppsala University · SE

Funding

NIDDK NIH HHS R01 DK105948
6 · The paper itself

Abstract

backgroundAssociations of obesity with incidence of heart failure have been observed, but the causality is uncertain. We hypothesized that gastric bypass surgery leads to a lower incidence of heart failure compared with intensive lifestyle modification in obese people.

methodsWe included obese people without previous heart failure from a Swedish nationwide registry of people treated with a structured intensive lifestyle program and the Scandinavian Obesity Surgery Registry. All analyses used inverse probability weights based on baseline body mass index and a propensity score estimated from baseline variables. Treatment groups were well balanced in terms of weight, body mass index, and most potential confounders. Associations of treatment with heart failure incidence, as defined in the National Patient Register, were analyzed with Cox regression.

resultsThe 25 804 gastric bypass surgery patients had on average lost 18.8 kg more weight after 1 year and 22.6 kg more after 2 years than the 13 701 lifestyle modification patients. During a median of 4.1 years, surgery patients had lower heart failure incidence than lifestyle modification patients (hazard ratio, 0.54; 95% confidence interval, 0.36-0.82). A 10-kg achieved weight loss after 1 year was related to a hazard ratio for heart failure of 0.77 (95% confidence interval, 0.60-0.97) in both treatment groups combined. Results were robust in sensitivity analyses.

conclusionsGastric bypass surgery was associated with approximately one half the incidence of heart failure compared with intensive lifestyle modification in this study of 2 large nationwide registries. We also observed a graded association between increasing weight loss and decreasing risk of heart failure.

Indexed as

LaparoscopyRisk Reduction BehaviorWeight LossAdultBody Mass IndexFemaleGastric BypassHeart FailureHumansIncidenceMaleObesityPropensity ScoreProportional Hazards ModelsProspective StudiesRegistriesbariatric surgerydiet, reducinggastric bypassheart failureweight loss

Identifiers

PMID28258170
PMCPMC5404408
OpenAlexW2593971221

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.